By Heart is a series in which authors share and discuss their all-time favorite passages in literature. See entries from Claire Messud, Jonathan Franzen, Amy Tan, Khaled Hosseini, and more.

Doug McLean

Virginia Woolf was no stranger to doctors: For much of her life she suffered from fevers, migraines, fainting spells, and the stark depressive episodes for which she’s well-known. In her essay “On Being Ill,” first published in T.S. Eliot’s journal The Criterion in 1926, Woolf taught a lesson learned from a life in sickbeds—that illness is epic, as worthy a topic as love and battle. But while warriors have the Greeks, and lovers have Keats and Shakespeare, she says, the sick lack a great bard. She implores readers to develop a poetic vocabulary for the body out of order, and calls us to pay attention to the ways pathology elevates our senses and enlivens our language.

When she discovered “On Being Ill,” The Empathy Exams author Leslie Jamison found welcome license in Woolf’s directive. In her essay for this series, Jamison explains how she felt pressure to steer clear of physicality in her work—to be ashamed of her fascination with the body and its many states of illness. She recalled how an accident left her physically speechless—a dramatic demonstration of Woolf’s proposition that the sick become mute—and explained why she wants to learn to utter, in her work, the many things a body can endure.

In The Empathy Exams, a nonfiction collection, we see this tendency at work. Jamison’s essays continually seek language to express her body’s history—a broken nose, a broken jaw, a fluky ventricle, a surprise pregnancy—to make her experiences brilliantly visible and thereby understood. But the exploration moves beyond her own wounds towards the suffering of others. In essays about poverty and its tourists, medical actors and career malingerers, wrongfully imprisoned convicts and the prison of the body, Jamison asks urgent questions about the nature of empathy itself: How can we say “I hurt” and be heard? How much of empathy is rooted in selfishness? And how might we, all of us, broaden the capacity of our hearts?

The Empathy Exams is winner of the Graywolf Press Nonfiction Prize. Jamison’s first book, The Gin Closet, a novel, was finalist for the Los Angeles Times Book Prize. Her essays have appeared in Harper’s, The Believer, Oxford American, and A Public Space. She lives in Brooklyn.

From Virginia Woolf’s “On Being Ill”:

“…strange indeed that illness has not taken its place with love and battle and jealousy among the prime themes of literature. Novels, one would have thought, would have been devoted to influenza; epic poems to typhoid; odes to pneumonia; lyrics to toothache. But no, with a few exceptions … literature does its best to maintain that its concern is with the mind; that the body is a sheet of plain glass through which the soul looks straight and clear, and, save for one or two passions such as desire and greed, is null, and negligible and non-existent. On the contrary, the very opposite is true. All day, all night the body intervenes; blunts or sharpens, colours or discolours, turns to wax in the warmth of June, hardens to tallow in the murk of February. The creature within can only gaze through the pane—smudged or rosy; it cannot separate off from the body like the sheath of a knife or the pod of a pea for a single instant; it must go through the whole unending procession of changes, heat and cold, comfort and discomfort, hunger and satisfaction, health and illness, until there comes the inevitable catastrophe; the body smashes itself to smithereens, and the soul (it is said) escapes. But of all this daily drama of the body there is no record.”

Leslie Jamison: “On Being Ill” isn’t just making a case for illness as a literary subject, but for the brute, bare fact of the body itself. By insisting we acknowledge that we sweat and crave and itch all day (“all day, all night”), Woolf reminds us we have the right to speak about these things—to make them lyric and epic—and that we should seek a language that honors them. The man who suffers a migraine, she writes, is “forced to coin words himself, taking his pain in one hand and a lump of pure sound in the other.” What does it sound like, this strange, unholy language of nerves and excretions? How do we articulate the kind of pain that refuses language? We throw up our hands, or we hurl our charts: one through ten, bad to worse, from the smiley face to its wretched, frowning cousin.

Woolf’s argument may have been more urgent in her time than in ours—we have more records of the “daily drama of the body” now than we did then—but when I first read her battle cry, her call to arms (not just arms but legs and teeth and bones), it felt like encountering a long-lost relative: the banner I’d never known I’d always been fighting under: Bodies matter—we can’t escape them—they’re full of stories—how do we tell them? Her argument might have the urgency of a battle cry but it’s also vulnerable; it’s posing questions; it’s got mess and nerve—it’s leaking some strange fluid from beneath its garments, hard to tell in the twilight, maybe pus or tears or blood. Even her syntax feels bodily—full of curves and joints and twists, shifting and stretching the skin of her sentences.

People have often told me my own writing seems to be all about bodies. A woman from a writing workshop once suggested I call my collection of stories Body Issues. (I didn’t have a collection of stories: If I did, I wouldn’t have called it that.) But I’ve never wanted to write about “the body,” by which I mean I’ve never set out with that explicit intention; I’ve only ever wanted to write about what it feels like to be alive, and it turns out being alive is always about being in a body. We’re never not in bodies: that’s just our fate and our assignment. (In her beautiful memoir The Two Kinds of Decay, Sarah Manguso writes that she despises “the body” whenever it describes anything but a corpse, and I love that, though I use the phrase constantly anyway.) To my mind, the more aggressive choice is writing that isn’t physical; this insistence carries the burden of intentional absence.

All that said, I’ve always felt a certain shame about the ways my writing keeps coming back to bodies, which is why I loved finding Woolf. My shame felt such relief at the prospect of her company. My first novel was all about addiction and eating disorders and sex, and there was food everywhere, some of it gone rotten. I used the word “sweat” too many times (my editor told me); there were too many fluids (my editor told me) and far too many bruises (my editor told me) and even worse, too many of these bruises were “plum-colored”—for this last one (my editor told me), we would both get mocked, if we didn’t get rid of some of these plum-colored bruises right away. A certain shame hung over the whole narrative, like a faint body odor I couldn’t smell because it was mine: There was too much body, and this too-much-body risked banality and melodrama at once. I’ve always wondered if this shame about writing about the body is connected to the shame of quasi-autobiographical writing, that sense of failing to imagine beyond one’s own experience. Is writing about bodily experience somehow the extreme form of this failure, the ultimate solipsism? You haven’t even gotten beyond your own nerve endings; it’s no accident they call it navel gazing.

I often think of an old painting I once saw that shows an injured body pointing at its own open wounds. The most graceful victim, of course, is the one who doesn’t need to point at his holes or ask for sympathy—who doesn’t take up the lump of pure sound, who just keeps quiet. The way I imagine being scolded goes something like this: There’s something selfish about talking about bodies too much if the bodily experience fueling everything is your own.

I often think, also, of a cross-country race I ran in 10th grade: I tripped on a slab of concrete sticking up from the dirt, about a hundred meters after the start, when the pack was still dense; and I was trampled by the horde of 15-year-old girls running behind me. It was pretty minor, as tramplings go. But still, it was a trampling. I got up to run the next three miles of the race but I was shaken up and bleeding. I wasn’t running well at all—nothing close to what I’d need to do to place well for our team.

When I reached my coach, who was calling out our one-mile splits, she said something to the effect of “Why are you running so slow?”—only perhaps not so delicately phrased. I remember the awkward way I tried to point at my own wounds without slowing my (turtle) pace; and I remember how badly I wanted her to see the streaks of dirt-clotted blood; I almost stumbled again in my urgent need to show her the proof of my stumbling.

That memory has become the vessel for a certain kind of shame—the shame of pointing too overtly at what hurts, jamming the laser-pointer of language at some wound and then expecting it to yield wisdom or explanation. My coach didn’t want the epic or lyric account of my damaged body, she just wanted me to keep running, and hopefully pick up the pace.

I’m still haunted by the specter of myself in this moment—a mute form pointing, bleeding. A few years after that race I spent a couple months actually mute: I’d gotten jaw surgery and they’d wired my jaw shut to help it heal. During those months I wrote quite frequently but it was mainly practical, because I couldn’t talk. I requested things by scribbling them in a little notebook: vicodin, please; okay ensure (my mom was always foisting Ensure on me), but are there any cans of dark chocolate left? HATE butter pecan. I asked for sheets draped over the mirrors, so I wouldn’t see my swollen face; I asked for the pair of scissors that I was supposed to keep on-hand in case I vomited and needed to cut the wires between my teeth.

Eventually I started writing poems about those quiet weeks, and the surgery before them, the days in the hospital. The poems were full of IV lines and numbness and feeling returning after numbness like water oozing back into crab holes in damp sand (“crackling lines of hurt,” I wrote). I imagined myself the bard of swelling; I wanted to write toothache lyrics for swelling—to evoke the chronic panic of its deforming sculptural practice: it shapes you into something like you, but not you. I wanted to bring that aching knowledge to my nonexistent reading public.

I turned the poems into a series and then I turned them in to my undergraduate writing workshop. The series was called “Waiting Room,” meaning the waiting room before surgery but also the injury afterward as a waiting room—get it?—the aftermath as the cramped little chamber where you wait to get better; where you have to keep waiting even once it seems like you should already be there.

I wasn’t satisfied with the poems. Pain was hard to describe. I encountered Elaine Scarry’s famous formulation—“pain does not simply resist language but actively destroys it”—which recognized but did not solve the problem. My workshop wasn’t satisfied with the poems either. Everyone wanted to know: What were they about? I thought it was pretty fucking self-evident, but no, it was a different problem: My classmates got that these poems were about pain and injury—maybe in a dental office?—but what were they really about? My workshop was thinking everything must be a metaphor for something else: the cut lines on raw gums, the self-quieting sparkle of anesthesia. But in truth, nothing was a metaphor for anything. It was more or less this happened, and it hurt. There was nothing below the surface.

At the time I took this as a verdict of poverty and lack—which is why I loved finding Woolf, so many years later, who seemed to be saying, the surface of the body isn’t poverty; it isn’t lack. She rose from the dead for the express purpose of silencing that workshop, or at least arguing against the notion that there had to be something besides bodies for these poems to matter. She was saying the surface is poetry; bodies are poetry; or poetry can be made of what these bodies need and crave and bleed and feel.

I felt her summoning an army, everyone I’d ever read whose language does some justice to the way our bodies are, the ways they betray us or bind us together: Walt Whitman’s greed to catalogue the physical forms of his countrymen, William Faulkner’s fixation on muddy drawers and the waft of honeysuckle; Marcel Merleau-Ponty’s insistence on the body as an “eloquent relic of existence.”

Woolf writes: “It is not only a new language that we need, more primitive, more sensual, more obscene, but a new hierarchy of the passions; love must be deposed in favour of a temperature of 104; jealousy give place to the pangs of sciatica.” I can see the way these marching orders have infected my own prose—even this piece, with its twisting, bodily contortions—and the way they’ve helped me claim a dialect I’d been afraid was junk, a ledger of the body’s travails, not the “Waiting Room” poems (which weren’t really that great) but the notebooks I kept when my jaw was wired silent, full of their banal complaints and requests: Vicodin, please. Where are the vomit scissors? These are daily dramas of the body, charged with force and longing; the record Woolf never found, the words that pain and pure sound made.

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